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NUR641E Advanced Pathophysiology & Pharamacology for Nurse Educators
Midterm Exam
 1    Heparin exerts its therapeutic action by:
     upregulating the activity of one of the body’s natural anticoagulant molecules, antithrombin III.
     deactivating calcium-dependent clotting factors.
     inducing prothrombin formation.
     inducing the formation of fibrin.
     2    Which method of drug administration can have immediate effects and requires lower doses compared to oral or parenteral administration?
     3    High altitudes may produce hypoxemia by:
     right-to-left shunts.
     decreased oxygen inspiration.
     All of the above
     4    Causes of hyperkalemia include:
     hyperparathyroidism and malnutrition.
     vomiting and diarrhea.
     renal failure and Addison’s disease.
     hyperaldosteronism and Cushing’s disease.
     5    Hypomagnesemia occurs when serum magnesium concentration is less than
     1.0 mEq/L.
     1.5 mEq/L.
     2.0 mEq/L.
     3.0 mEq/L.
     6    When looking at arterial blood gas readings, you discover the following: pH 7.26, pCO2 56, HCO3 24. What condition are you dealing with?
     Respiratory alkalosis
     Metabolic acidosis
     Metabolic alkalosis
     Respiratory acidosis
     7    A drug with a half-life of 10 hours is administered by continuous intravenous infusion. Which of the following best approximates the time for the drug to reach steady state?
     10 hours
     30 hours
     40 hours
     60 hours
     8    Which NSAID is generally considered the safest for use in patients with coronary artery disease?
     9    Pulmonary hypertension:
     shows an enlarged pulmonary artery.
     involves deep vein thrombosis.
     shows right ventricular hypertrophy.
     A and C are correct
     10    Which stage of infection is occurring when the immune and inflammatory responses are triggered?
     Incubation period
     Prodromal stage
     Invasion period
     11    Which of the following agents is used to treat hypercalcemia of malignancy?
     Activated vitamin D
     Pamidronate (Aredia)
     12    Which statement is true regarding the pharmacokinetics of drug administration?
     The immature liver or kidneys of the very young may accelerate drug metabolism and excretion.
     Medications enter the body in solid form and change into solution for absorption and utilization.
     It includes medication absorption, distribution to tissues, metabolism, and elimination from the body.
     A therapeutic effect occurs as the medication reaches the target cell.
     13    Which statement is true regarding the half-life of medications?
     Doubling the dose will double the medication half-life.
     Approximately 2 half-lives are required for a medication to be completely eliminated.
     Patients with renal or hepatic disease usually have decreased half-lives.
     The half-life of a drug helps determine how often the drug is to be administered.
     14    Cell wall inhibitors include all of the following except
     15    Which of the following factors do not influence bioavailability?
     First-pass hepatic metabolism
     Solubility of the drug
     Chemical instability
     16    Which class of diuretics treats hypertension by increasing sodium and water retention?
     Loop diuretics
     Thiazide diuretics
     Potassium sparing diuretics
     Aldosterone inhibiting diuretics
     17    What is the action of calcitonin?
     Increases metabolism.
     Decreases metabolism.
     Increases serum calcium.
     Decreases serum calcium.
     18    The nurse has a patient who has been on multidrug therapy for pulmonary tuberculosis. When planning patient education, the nurse knows the patient needs to watch for which symptom of an adverse effect of multidrug therapy?
     Hearing loss
     Changes in vision
     Generalized pruritus
     19    The spread of microorganisms from mother to the baby across the placenta is termed
     direct transmission.
     vertical transmission.
     horizontal transmission.
     indirect transmission.
     20    Which antimicrobial should be avoided in children because it is deposited in tissues undergoing calcification and can stunt growth?
     21    The primary role of cytochrome p-450, in the liver, is to:
     stimulate steroid release as a stress response.
     deactivate and detoxify medications and other substances.
     produce fibrinogen, prothrombin, and factor V.
     eliminate amino acids, forming urea.
      22    Death from influenza usually results from
     high temperature.
     metabolic alkalosis.
     23    Which of the following statements is true regarding bioavailability?
     It has little effect on the pharmacokinetics of orally-administered drugs.
     It is a drug-specific property; therefore, bioavailability will be the same regardless of the dosage form used.
     IV-administered drugs have a bioavailability of between 50 and 75 percent.
     It is defined as the amount of administered drug that is available to reach the site of action.
     24    Which of the following agents is considered a CYP3A4 inhibitor and should be used with caution in patients taking CYP3A4 substrates?
     25    Which of the following drugs are not considered for use with angina?
     Beta blockers
     Calcium channel blockers
     ACE inhibitors
     26    How many months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells?
     1 to 2
     4 to 5
     6 to 8
     10 to 12
      27    Low plasma albumin causes edema as a result of a reduction in which pressure?
     Capillary hydrostatic
     Interstitial hydrostatic
     Plasma oncotic
     Interstitial oncotic
     28    What mechanism can cause hypernatremia?
     Syndrome of inappropriate antidiuretic hormone
     Hypersecretion of aldosterone
     Brief bouts of vomiting or diarrhea
    Excessive diuretic therapy
     29    What is the direct action of atrial natriuretic hormone? (Select all that apply.)
     Sodium retention
     Sodium excretion
     Water retention
     Water excretion
     30    Which of the following increases the potential of cardiac toxicity if taken concurrently with digoxin?
      31    Which of the following corticosteroids has the shortest half-life and thus must be dosed most frequently?
      32    What causes the rapid change in the resting membrane potential to initiate an action potential?
     Potassium gates open, and potassium rushes into the cell, changing the membrane potential from negative to positive.
     Sodium gates open, and sodium rushes into the cell, changing the membrane potential from negative to positive.
     Sodium gates close, allowing potassium into the cell to change the membrane potential from positive to negative.
     Potassium gates close, allowing sodium into the cell to change the membrane potential from positive to negative.
      33    Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?
     Increased norepinephrine
     Angiotensin II
     Insulin resistance
     34    The major therapeutic actions of NSAIDS include all of the following except
    reduction of inflammation.
     reduction of pain.
     reduction of fever.
     reduction of clotting factors.
      35    What is an example of compensatory hyperplasia?
     Hepatic cells increase cell division after part of the liver is excised.
     Skeletal muscle cells atrophy as a result of paralysis.
     The heart muscle enlarges as a result of hypertension.
     The size of the uterus increases during pregnancy.
     36    A patient with type 1 diabetes has been made NPO after midnight for surgery. Knowing that the patient needs to continue the insulin pump to prevent diabetic ketoacidosis, what would be an expectation of treatment?
     Bedtime snack before midnight
     Dextrose containing intravenous fluids
     2am glucose check followed by apple juice if needed
     Discontinue the insulin pump
      37    Bacteria that produce endotoxins that stimulate the release of inflammatory mediators that produce fever are called
     pyrogenic bacteria.
    true bacteria.
     38    A 68-year-old male has COPD with moderate airway obstruction. Despite using salmeterol daily, as prescribed, he reports continued symptoms of shortness of breath with mild exertion. Which one of the following agents would be an appropriate addition to his current therapy?
     Systemic corticosteroids
     39    Aldosterone directly increases the reabsorption of (select all that apply):
     40    The most common cause of lower respiratory tract infection is
     aspiration of oropharyngeal secretions.
     not receiving the vaccine.
     refusing to cough and take deep breaths.
     remaining in bed until postop day two.
     41    Which of the following is true regarding prodrugs?
    They are affected considerably by renal function.
     They are better than amateur drugs.
     They are designed to overcome undesirable properties of an active drug.
     They may be more effective in patients with liver dysfunction.
      42    In the immediate postnatal period, infants lose approximately 5% of body weight due to
     loss of body water
     inability of the body to digest nutrients
     hemolysis of red blood cells
     poor sucking reflex
      43    Which of the following best describes the mechanism of action of warfarin?
     Directly inhibits factor Xa
     Inhibits factors II, VII, IX, and X
     Blocks the conversion of fibrinogen to fibrin
     Upregulates antithrombin III
     44    When looking at arterial blood gas readings, you discover the following: pH 7.75, pCO2 24, HCO3 40. What condition are you dealing with?
     Respiratory alkalosis
     Metabolic acidosis
     Metabolic alkalosis
     Respiratory acidosis
     45    In the absence of susceptibility data for an acute infection, the choice of an antimicrobial drug is mostly influenced by
     the site of infection and the patient’s history.
     the sensitivity report and the colony count.
     the source of the infection and the color of exudate.
     the host defense mechanism and the immune response.
     46    All of the following can be a likely cause of respiratory acidosis except:
     pulmonary edema.
     barbiturate overdose.
     extreme fear and anxiety.
     47    An increase of carbon dioxide in arterial blood causes chemoreceptors to stimulate the respiratory centers to:
     decrease respiratory rate.
     increase respiratory rate.
     develop hypocapnia.
     develop hypercapnia.
     48    The leading cause of death from a curable infectious disease throughout the world is
    HIV infection.
     49     Which condition poses the highest risk for a cerebrovascular accident (CVA)?
    Insulin-resistant diabetes mellitus
    50    Pulmonary emboli do not cause which of the following?
    Obstruct blood supply to lung parenchyma
    Have origins from thrombi in the legs
    Occlude pulmonary vein branches
    Occlude pulmonary artery branches

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